To the Editor.—
We read with interest the article by Kanzler et al1 and are inclined to agree with their contention that "Bart's syndrome is not a specific syndrome at all." The different case reports described under this heading since the original Bart's pedigree came to light in 1966, including our five cases,2 in fact present different modes of inheritance, different clinical findings with scarring and nonscarring lesions, and varied electron microscopic and immunohistologic findings, thus representing different types of epidermolysis bullosa (EB). If there is something to distinguish Bart's syndrome from other types of EB, it is its benign course and the eventual arrest of the lesions. This was not mentioned by Kanzler et al, who mistakenly included even a lethal case3 in their list of supposed Bart's syndrome patients. We suggest that all cases reported to date as Bart's syndrome be incorporated under the heading
Amichai B, Metzker A. Is Bart's Syndrome a Specific Syndrome? Arch Dermatol. 1993;129(7):907–908. doi:10.1001/archderm.1993.01680280097021
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